The impact of in-centre haemodialysis treatment on the everyday life of older adults with end-stage kidney disease: a qualitative study.

activities of daily living haemodialysis older adults quality of life rehabilitation

Journal

Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 10 01 2023
medline: 2 10 2023
pubmed: 2 10 2023
entrez: 2 10 2023
Statut: epublish

Résumé

Older adults with end-stage kidney disease experience a diminished ability to perform the activities of their daily life. For those living at home, the initiation of in-centre haemodialysis treatment (ICHD) carries a risk of cascading functional decline leading to early nursing home placement and mortality. Research on how older adults adapt to their newly impacted daily life is scarce. Individual semi-structured interviews were conducted using a purposeful maximum variation sample of older adult (≥65 years) ICHD patients living at home. Interviews were conducted between October and December 2018. Interview coding followed an inductive and broad-based approach. Thematic analysis was used to group meaning units into common themes and subthemes. Twenty patients (12 females) were interviewed. Analysis resulted in two main themes and seven subthemes. The first main theme showed the impact of ICHD on everyday roles and functioning through four subthemes: a stepwise decline in daily activities, managing time, role changes and an incomplete retirement. The second main theme showed potential areas of remediation through three subthemes: the social environment, developing new daily activity patterns and meaningful activities and goals. The older adults experienced a process of adaptation that generally progressed from a phase of initial disruption towards a period of mere survival. Being able to accept a life on dialysis was intricately connected with the ability to perform activities that were personally meaningful. Early and continued support of meaningful activities may prove valuable in breaking or delaying the cycle of functional decline.

Sections du résumé

Background UNASSIGNED
Older adults with end-stage kidney disease experience a diminished ability to perform the activities of their daily life. For those living at home, the initiation of in-centre haemodialysis treatment (ICHD) carries a risk of cascading functional decline leading to early nursing home placement and mortality. Research on how older adults adapt to their newly impacted daily life is scarce.
Methods UNASSIGNED
Individual semi-structured interviews were conducted using a purposeful maximum variation sample of older adult (≥65 years) ICHD patients living at home. Interviews were conducted between October and December 2018. Interview coding followed an inductive and broad-based approach. Thematic analysis was used to group meaning units into common themes and subthemes.
Results UNASSIGNED
Twenty patients (12 females) were interviewed. Analysis resulted in two main themes and seven subthemes. The first main theme showed the impact of ICHD on everyday roles and functioning through four subthemes: a stepwise decline in daily activities, managing time, role changes and an incomplete retirement. The second main theme showed potential areas of remediation through three subthemes: the social environment, developing new daily activity patterns and meaningful activities and goals.
Conclusions UNASSIGNED
The older adults experienced a process of adaptation that generally progressed from a phase of initial disruption towards a period of mere survival. Being able to accept a life on dialysis was intricately connected with the ability to perform activities that were personally meaningful. Early and continued support of meaningful activities may prove valuable in breaking or delaying the cycle of functional decline.

Identifiants

pubmed: 37779844
doi: 10.1093/ckj/sfad104
pii: sfad104
pmc: PMC10539253
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1674-1683

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest.

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Auteurs

Timothy Moreels (T)

Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Department of Nephrology, Ghent University Hospital, Ghent, Belgium.

Dominique Van de Velde (D)

Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Department of Occupational Therapy, Artevelde University of Applied Sciences, Ghent, Belgium.

Stephanie Van Duyse (S)

Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.

Karsten Vanden Wyngaert (K)

Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Department of Nephrology, Ghent University Hospital, Ghent, Belgium.

Tamara Leune (T)

Department of Nephrology, Ghent University Hospital, Ghent, Belgium.

Wim Van Biesen (W)

Department of Nephrology, Ghent University Hospital, Ghent, Belgium.

Patricia De Vriendt (P)

Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Department of Occupational Therapy, Artevelde University of Applied Sciences, Ghent, Belgium.
Frailty in Ageing Research Group, Department of Gerontology and Mental Health and Wellbeing Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit, Brussels, Belgium.

Classifications MeSH